Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Huntington's Disease Society of America (HDSA) Center of Excellence at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
Behav Brain Res. 2024 Feb 26;458:114767. doi: 10.1016/j.bbr.2023.114767. Epub 2023 Nov 19.
Obsessive-compulsive and perseverative behaviors (OCBs/PBs) are characteristic features of Huntington's Disease (HD). Although a few recent research have attempted to discriminate between OCBs and PBs, most of the available evidence on OCBs does not consistently make this distinction. In this article, we aimed to explore the current inconsistencies in assessing and reporting OCBs/PBs and map the body of existing evidence. Up to half of the patients with motor manifest HD can experience OCBs. Separate reporting of PBs in HD patients has been uncommon among the studies and was frequently reported as a part of obsessive-compulsive symptoms. The structural limitation of the currently used rating scales and the overlaps in neuropathology and definition of OCBs and PBs are among the main reasons for the mixed reporting of OCBs/PBs. Perseverative thinking or behavior as a separate item is found in a few assessment tools, such as the Problem Behaviors Assessment - Short form (PBA-s). Even when the item exists, it is commonly reported as a composite score in combination with the obsessive-compulsive item. In addition to the significant psychological burden in individuals with HD, PBs are associated with somatic effects (e.g., cardiovascular symptoms) and high-risk behaviors (e.g., suicide). Recognition and monitoring of PBs in HD can aid in early detection of concerning symptoms and differentiating overlapping illnesses.
强迫与持续行为（OCBs/PBs）是亨廷顿病（HD）的特征性表现。尽管最近有几项研究试图区分 OCBs 和 PBs，但大多数关于 OCBs 的现有证据并未一致做出这种区分。在本文中，我们旨在探讨评估和报告 OCBs/PBs 方面目前存在的不一致，并绘制现有证据图谱。多达一半的运动表现型 HD 患者可出现 OCBs。HD 患者的单独 PB 报告在研究中并不常见，通常作为强迫症状的一部分进行报告。目前使用的评分量表的结构性限制以及 OCBs 和 PBs 的神经病理学和定义上的重叠是 OCBs/PBs 混合报告的主要原因之一。在一些评估工具中，如问题行为评估-简表（PBA-s），将持续思维或行为作为单独项目。即使存在该项目，它通常也会与强迫性项目一起作为综合得分报告。除了 HD 患者存在显著的心理负担外，PBs 还与躯体效应（如心血管症状）和高风险行为（如自杀）相关。在 HD 中识别和监测 PB 有助于早期发现令人担忧的症状，并区分重叠疾病。
